Apparatus for the treatment of bone fractures



May 5, 1970 YE. PILZ 3,509,876

APPARATUS FOR THE TREATMENT OF BONE FRACTURES I Filed Feb. 27, 1967 a Sheets-Sheet 1 Fig. 7

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May 5, 1970 E. PlLZ 3,509,876

APPARATUS FOR THE TREATMENT OF BONE FRACTURES Filed Feb. 27, 1967 2 Sheets-Sheet 2 United States Patent 3,509,876 APPARATUS FOR THE TREATMENT OF BONE FRACTURES Erwin Pilz, Rastatt, Germany, assignor to Stierlen-Werke Aktiengesellschaf't, Rastatt, Germany Filed Feb. 27, 1967, Ser. No. 618,972 Claims priority, application Germany, Oct. 18, 1966,

Int. cl. Aim /04 U.S. Cl. 128-84 6 Claims ABSTRACT OF THE DISCLOSURE An apparatus for medical purposes, especially for the treatment of bone fractures, which is equipped with arm means which can be moved into and out of superimposed positions while each of said arm means is composed of a plurality of links which can selectively be decreased and increased in number and can be pivoted and arrested relative to each other. Movement in any direction of one arm means is possible without interfering with or impeding the movement of other arm means particularly for extension pulling and X-ray diagnoses use of the apparatus.

The present invention relates to an extension apparatus with link means comprising extension spars or arms, especially for the closed marrow nailing while employing modern X-ray devices.

Extension apparatuses are known which comprise extension spars arranged slightly below the supporting surface for the patient and pivotable about the supporting axis While being rigid and partially also self-supporting and designed in a cantilever fashion.

With the introduction of the picture amplifier X-ray devices into the operating room, considerable difficulties have been encountered with the rigid extension spars which are located below the extremities of the patient, said difficulties forcing the designer generally to place the extension spars close to the floor. This forced the designer to give up the possibilities of inclining the apparatus which possibilities are highly advantageous for the operative treatment of the patient, and according to which it was heretofore possible to incline the patient toward the right or toward the left, or to incline the head end or foot end portions of the apparatus. In case of locating the extension spars slightly above the floor, such inclinations were not at all possible, or only to a very minor degree.

All designs with rigid extension spars have the drawback that for purposes of adapting the apparatus to the different types of treatment and to the size of the patient, it was necessary to make the extension spars telescopically displaceable or to equip the device with holding and supporting means for the extremities and to make these holding and supporting means displaceable in the longitudinal direction of the spars. The telescopic displaceability of the spars, as well as the displaceability of the holding and supporting devices require relatively expensive structures, and in addition thereto, have to be carefully serviced in order to maintain the device in good working condition.

It is, therefore, an object of the present invention to provide an extension apparatus which will overcome the above mentioned drawbacks.

It is another object of this invention to provide an extension apparatus which will permit an unimpeded employment of modern X-ray devices as, for instance, X-ray picture amplifiers and television screen.

It is still another object of this invention, to provided an extension apparatus as set forth in the preceding paragraph, which will permit an optimum placement of the patient for treatment of all tyes of bone fractures.

These and other objects and advantages of the invention will appear more clearly from the following specification in connection with the accompanying drawings, in which:

FIG. 1 diagrammatically illustrates a side view of the extension apparatus according to the invention.

FIG. 2 shows a top view of FIG. 1.

FIG. 3 is a section through an extension spar joint, but on a larger scale than that of FIGS. 1 and 2.

FIG. 4 shows in top view a mode of employment of the extension apparatus according to the invention, for treating the neck of the leg.

FIG. 5 shows the apparatus according to the present invention in connection with the nailing of the upper thigh.

The apparatus according to the present invention is characterized primarily in that the extension spars are composed of a plurality of spar links which are interconnected by means of arrestable links and which are so arranged and designed as to permit numerous variable modes of employment. The extension spar links which are pivotally connected and are arrestable at desired positions relative to each other afford the possibility to evade the pivotal range of the X-ray device without effecting the pulling direction of the extension while the extension spars can be arranged in a cantilever fashion closely below the supporting plane for the patient, Moreover, all possibilities of inclining and adjusting the operating table as to height will be maintained. By a corresponding pivotal movement, withdrawal or insertion of individual spar members, it is possible by means of simple and nonsensitive structural elements to adapt the apparatus to any mode of locating the patient, and to any size of the patient.

More specifically, referring to the drawings, the apparatus shown therein comprises a movable foot portion 1 which, if the apparatus is stationarily located, may be omitted. Foot portion 1 supports a column 2 which is telescopically adjustable as to height and which, in its turn, supports a chassis 3. Chassis 3 forms the support for the patient supporting means, and also forms the support for the mounting of the spars. When the column 2 is arranged stationarily, the structure may be such that the entire chassis with all mountings therein can be lifted off the column 2 while the adjusting elements remain entirely or partially in the chassis 3 or form a component of the stationary column 2. Advantageously, the supporting means for the patient is subdivided into a thorax plate 6 and a pelvis plate 7 which plates are adapted to be adjusted as to height either individually or together by means of supports 4, 5 for applying a thorax or pelvis plaster of Paris cast in a manner known per se. There is furthermore provided a pelvis supporting tongue 8 for supporting the patient.

The extension spars are by means of their hubs 16 and 26, pivotally arranged in superimposed arrangement so as to be pivotable about a common axis which may also be the axis of the counter pull rod 9. The arresting of the extension spars in their respective desired position is effected by means of a screw 10 which axially presses the tooth equipped end faces of the hubs against each other and against the supporting means on chassis 3, which supporting means also have their end faces provided with teeth. Thus, by means of this device, the main elements 11 and 21 of the extension spars are adjustable relative to each other with regard to chassis 3 and are pivotable or swingable about a common axis and are arrestable in their respective position.

The main elements 11 and 21 respectively have pivotally connected thereto intermedate arms 12, 22 which in their turn have pivotally connected thereto, the end members or arms 13, 23. The arms 11, 21 are respectively pivotally connected to the arms 12, 22 by joints 14 and 24, whereas the arms 12 and 22 are respectively pivotally connected to the arms 13 and 23 by joints 15 and 25 respectively. For arresting the joint members relative to each other there are advantageously employed end face teeth 112, 122 of the hub 111, 121, adapted to be pressed in axial direction by means of screw bolts 141 and nuts 142.

The end members 13, 23 are adapted to receive and support pulling units 17, 27 which are known per se, and do not form a part of the present invention. These pulling units are, in a manner known per se, adjustable as-to height and pivotal in all directions.

Advantageously, one of the two main members 11, 21, is shorter than the other by at least the diameter of the hub of the joint. The total length of the spar is compensated for by correspondingly extending the end members 13, 23. This design makes it possible to arrange the spars closely one above the other in spite of the bulky joints 14, 15; 24, 25. In this way, the said spars can easily be pivoted toward the right or toward the left past each other, while selectively the upper member 11 may pass toward the right or the left and the shorter arm 11 or the longer arm 21 will move to the desired side. This exchangeability with regard to the limbs to be treated assures a good adaptation to the size'of the patient while affording an optimum accessibility for the operating physician and for the X-ray device. In particularly diflicult instances, when high extension pulling forces are employed, the two spars can be moved so as to be vertically aligned and can at the end members 13, 23, by means of the vertical bar of the pulling unit 17 or 27 be united to a particularly bend resistant extension bar.

By withdrawing the intermediate member 12, 22, the extension spar can be shortened, if so desired. Similarly, it is possible to obtain an extension of the apparatus by additional intermediate members by transferring the intermedaite member removed from the shortened spar into the spar to be extended. To this end, the spar elements are easily detachable and exchangeable with regard to each other, as clearly shown in FIG. 3.

FIG. 4 shows the device in a position for treating the neck of the-leg, and also shows how by pivoting the spars 12 and 13; 22 and 23 with regard to each other it is pos sible to adapt the device to the lengths of the legs of the patient.

FIG. shows the apparatus according to the invention, in a position for nailing the upper thigh marrow. More specifically, FIG. 5 shows the extension spar shortened by the withdrawal of the intermediate member 22 for the main extension pull on the thigh, and also shows the,

other spar extended by the intermediate member 22 for holding the lower leg. By means of this extension, it is made possible to evade or avoid an interference with the tilting range of the X-ray device R. Differentiated length adaptations can be obtained if, for instance, the long member 21 is combined with the long end member 13 or inversely if the short main member 11 is combined with the short end member 23, or if for intermediate lengths, short links 11, 23 are combined with long links 21, 13.

It is, of course, to be understood that the present invention is, by no means, limited to the particular arrangement shown in the drawings, but also comprises any modifications within the scope of the invention. Thus, if desired, the pivot axes of the main members 11, 21 may be arranged adjacent to each other. Furthermore, only one spar may be equipped with a plurality of links. It is also to be understood that for arresting the joints in their positions, other machine elements may be employed. By correspondingly swinging and pivoting the spar links, it is also possible to employ the apparatus according to the invention to the upper extremities of the patient.

What is claimed is:

1. An extension apparatus, especially for treatment of bone fractures, which includes: a chassis, means for supporting said chassis, supporting means carried by said chassis for supporting a patient to be treated, articulated supporting arm means having one end thereof pivotally connected about a first pivot axis relative to said chassis and having the other end thereof provided with means for receiving and supporting pulling means, said articulated supporting arm means including in combination at least three pivotally interconnected links movable for ex tension pulling and displaceable more eflectively during use with X-ray diagnosis, each link being pivoted to its adjacent link about an additional pivot axis entirely parallel to the first pivot axis, said articulated supporting arm means including both an upper arm and a lower arm, each of said upper arm and said lower arm in respective combination having at least three pivotally interconnecting links, each of said upper and lower arms having a pivotally interconnected link at the innermost respective chassis ends of said upper and lower arms pivoted about a common first pivot axis, and means for selectively arresting adjacent links in their respective pivotally adjusted positions.

2. An apparatus according to claim 1, in which each of said links of both said upper arm and said lower arm respectively comprises a hub and in which adjacent links of the hub arm have their hubs pivotally connected to each other and in which adjacent links of said lower arm have their hubs pivotally connected to each other, the innermost link of at least three links of one of said arms being shorter than the innermost link of at least three links of the other arm by at least the diameter of the adjacent hub of said other arm for parallel but offset spaced axis relationship of respective links of said upper and lower arms.

3. An apparatus according to claim 2, in which the outermost link of at least three links of one arm is longer than the outermost link of at least three links of the other arm by substantially the same distance by which the innermost link of said one arm is shorter than the innermost link of said other arm for progressive compatibility of parallel but offset spaced axis relationship of respective links of said upper and lower arms.

4. An apparatus according to claim 1, which includes a counter pullrod that projects substantially coaxially arranged together with said common first pivot axis.

5. An apparatus according to claim 1, in which the individual links of each combination of at least three links are interchangeable and removable respectively from one arm and insertable into the other arm.

6. An apparatus according to claim 1, in which intermediate links are pivotally connectable respectively and individually in addition to at least said three links of each of said two arms.

References Cited UNITED STATES PATENTS 300,428 6/1884 Zanger 287-14 XR 1,074,272 9/ 1913 Kline. 1,113,658 10/1914 Landenberger 12884.2 1,266,367 5/ 1918 Wilson. 1,697,121 1/ 1929 Knebel 128--84.2 2,658,507 11/ 1953 Neufeld 128-842 FOREIGN PATENTS 723,420 1/ 1932 France.

OTHER REFERENCES Castle Pelvic Anchor Sacral Rest, Wilmot Castle Company, Rochester 7, N.Y., Brochure No. 18, p. 4. Received in US. Patent Oflice July 2, 1954.

RICHARD A. GAUDET, Primary Examiner R. L. FRINKS, Assistant Examiner US. Cl. X.R. 12s 71; 269--328 

